By Dr. Shawna Darou, ND
I’m writing this article, because I have noticed a pattern in quite a number of patients lately and hope that this short article may help you put the pieces together for your own health if you are experiencing symptoms of histamine intolerance.
Common symptoms associated with histamine intolerance include:
- migraines / headaches
- hives, or itching in general
- sinus congestion
- worsening PMS and or period cramps
- flare-up of allergic-conditions such as eczema or asthma
- brain fog
As you can see, this constellation of symptoms affects several different systems and without knowing the link you may not see the connection. The ones I see most commonly are nausea, headaches and palpitations. Flushing is a classic histamine-intolerance sign, but I don’t see this in all cases.
Since there is no accurate test to diagnose histamine intolerance, we can assess with the combination of a low-histamine diet, along with natural antihistamine supplements like quercetin. In all cases, symptoms worsen from high-histamine foods because it increases the load of histamines and aggravates symptoms.
High histamine foods
It is rare that a diet high in histamines is the only cause of histamine intolerance, however minimizing these foods can make a big difference in receiving symptoms while we get to the root of it. Do you get a headache or nausea from eating pickled foods, smoked fish, leftovers, wine or tomatoes? There are many very healthy foods on a high histamine food list, so chances are you are eating them regularly.
This is a list of the highest histamine foods – please note this is not a completely thorough list, I have simplified for this article:
- Leftover meats and fish (foods stored in the fridge become higher in histamine the longer they are kept)
- Smoked or cured meats and fish
- Fermented foods – pickled vegetables, miso, sauerkraut, kimchi, alcohol (especially wine, beer, champagne), soy sauce, yogurt, kefir, aged cheeses, kombucha, vinegar
- Tomato, spinach, eggplant, avocado
Causes of histamine intolerance
This is where we need to do some investigating to find out what has changed to create a histamine intolerance.
(1) SIBO (Small intestine bacteria intolerance)
SIBO is one of the most common causes of histamine intolerance, and would be suspected if there are also symptoms such as:
- Upper abdominal bloating and belching
- Change in bowel movements (can be constipation or diarrhea)
- Nausea, acid reflux
- Gassiness or bloating from probiotics
- Abdominal weight gain that doesn’t make sense
- Increased food sensitivities
- Poor nutrient absorption (iron and vitamin B12 especially)
SIBO is short for “Small Intestinal Bacteria Overgrowth,” and what this means is that bacteria growth in the small intestine has gotten out of balance. The bacteria in your gut is extremely important, and forms part of your microbiome. Gut bacteria however are meant to be located in the large intestine and colon, and when these healthy bacteria colonize the small intestine, SIBO occurs. These displaced bacteria in the small intestine ferment the carbohydrates and sugars you eat, and cause hydrogen gas to be produced. This hydrogen can then feed an organism in the small intestine called archaea, which then produce methane gas. It is these gasses that cause many of the symptoms of SIBO: bloating, acid reflux, belching and food sensitivities.
Some people have an inherited dysfunction or deficiency of the enzymes that break down histamine – N-methyltransferase (HNMT) and diamine oxidase (DAO), meaning they are not able to get rid of excess histamine and would experience symptoms with a lower histamine load.
The list of medications that cause low DAO enzymes is growing, and some are very commonly used such as ibuprofen, aspirin, many antidepressants (Cybalta, Effexor, Prozac, Zoloft), antiarrhythmic medications, H2 blockers (Pepcid, Zantac).
(4) Increase in high-histamine foods and beverages
In many cases, an increase in high-histamine foods such as a sudden increase in fermented foods can trigger symptoms of histamine intolerance, or an increase in alcohol consumption.
I hope there are a few of you reading this article who see how the pieces fit together for a set of seemingly unrelated symptoms. If you’re experiencing some of the high histamine signs above, please book in for an appointment soon so you can move forward with less headaches, nausea, brain-fog and itching!